205268 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1
ONE CIVIC SQUARE RED WING SHOE STORES INC
CHECK AMOUNT: $475.49
CARMEL, INDIANA 46032 6653E 82ND ST
INDPLS IN 46250 CHECK NUMBER: 205268
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 5100000395 300.00 MATERIALS SUPPLIES
2201 4356003 51000003978 175.49 SAFETY ACCESSORIES
Original Invoice
BILL TO REMIT TO
ATTN: BONNIE CALLAHAN Red Wing Shoe Store
CARMEL CITY STREET DEPT Castleton Village
3400 W 131ST ST 6653 East 82nd St.
CARMEL, IN 46074 Indianapolis, IN 46250 -4577
(317) 577 -0760
Invoice Number Invoice Date Terms Description
510000003978 12/31/2011 Net 30
Ticket Date Purchased By Other Information Lem Amount
00051035559 12/28/2011 1-UGGINBOTHOM, BILLY 02246D 105 175.49
Total $175.49
Net Total $175.49
Total Merch $175.49
Customer Tax $0.00
Maj. Acct. Tax $0.00
Message: Total Charges $175.49
Customer Payment $0.00
Maj. Acct. Payment $0.00
Total Due $175.49
Date Due 01/30/2012
1
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/31/11 510000003978 $175.49
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
VOUCHE NO. WAR NO.
ALLOWED 20
Red Wing Shoe Store
IN SUM OF
6653 E. 82nd Street
Indianapolis, IN 46250 -4577
$175.49
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 510000003978 43- 560.03 $175.49 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Tuesd4 Ja ta 03, 2012
v 11GV E
Street CommissiqUr
Street Cnmmssiener
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Original Invoice
BILL TO- REMIT TO
ATTN: KERRI LOVEALL Red Wing Shoe Store
CITY OF CARMEL UTILITIES/WATER Castleton Village
CITY OF CARMEL UTILITIES 6653 East 82nd St.
760 THIRD AVE. S.W. Indianapolis, IN 462504577
CARMEL, IN 46032 (317) 577 -0760
Invoice Number Invoice Date Terms Description
510000003959 12/23/2011 Net30
Ticket Date Purchased By Other Information tem AmoLnt
00051035280 12/09/2011 BRENNAN, PETER 02240E2085 157.49
Customer Tax 0.52
Total $158.01
Customer Payment $8.01
Net Total $150.00
00051035447 12/21/2011 STEWART, JASON J Employee #2126 02270D 110 193.49
Customer Tax 3.04
Total $196.53
Customer Payment $46.53
Net Total $150.00
Total Merch $350.98
Customer Tax $3.56
Maj. Acct. Tax $0.00
Message: Total Charges $354.54
Customer Payment $54.54
Maj. Acct. Payment $0.00
Total Due $300.00
Date Due 01/22/2012
1
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
264001
RED WING SHOE STORES INC Purchase Order No.
6653 E. 82ND STREET Terms
INDIANAPOLIS, IN 46250 Due Date 12/30/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201' 5100000039! $300.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 116525 WARRANT ALLOWED
264001 IN SUM OF
RED WING SHOE STORES INC
6653 E. 82ND STREET
INDIANAPOLIS, IN 46250
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
51000000395 01- 7200 -01 $150.00
51000000395 01- 7202 -06 $150.00
r"
i
i
I
Voucher Total $300.00
Cost distribution ledger classification if
claim paid under vehicle highway fund